Antidepressants bad for kids, Britain says

December 11, 2003|By The Washington Post.

WASHINGTON — British health officals warned doctors Wednesday against prescribing most newer antidepressants to children, saying the benefits of popular drugs such as Zoloft, Celexa and Lexapro are outweighed by the risks of triggering suicidal thoughts, self-injury and agitation.

In a warning that comes as the U.S. Food and Drug Administration is doing its own review of the safety of the same medications, the Medicines and Healthcare Products Regulatory Agency said the benefits outweigh the risks only for Prozac, the first of the modern generation of antidepressants.

"The experts have decided these medicines may do more harm than good in the treatment of depression in under-18s," the British agency said in a leaflet given to patients. Previously, British regulators had warned against giving Paxil and Effexor to children.

The FDA is using "a fine-toothed comb" to re-examine 20 studies of eight antidepressants, an official said. The agency has asked the drug companies that did the studies to provide the data in a format that makes comparisons easier. A panel of FDA experts is expected to weigh in February on the safety of giving the drugs to children.

Russell Katz, director of the FDA's division of neuropharmacological drug products, said the U.S. analysis will be more detailed than the British review. Combining different studies allows regulators to compare the collective risk of suicidal thoughts and agitation in depressed children who took the drugs versus those who got dummy pills. More than 4,100 kids participated in the 20 studies.

The medications being evaluated are called selective serotonin reuptake inhibitors, or SSRIs. Over the past decade, SSRIs have become the medicine of choice for treating depression in adults. While only Prozac has been specifically approved for children with depression, some studies indicate that the use of SSRI prescriptions for children is rapidly rising.

One study this month in the Archives of General Psychiatry concluded that about 1 percent of American children are treated for depression in any year and 57 percent of those get antidepressants, said Mark Olfson, the lead author.

While Olfson's study did not analyze why so many children were given antidepressants, he said the lack of trained child psychiatrists and psychologists might be prompting a swifter resort to prescription pads.